MRCOG Part 1 PHARMACOLOGY MCQ's + ANSWERS

1) The action of the coumarin anticoagulants may be potentiated by

Effect enhanced by Cimetidine & Sulphonamides(Enzyme inhibition)
T a) Sulphonamides & Broad spectrum A/B(reduce Vitamin k absorption).
F b) Phenylbutasone Warfarin inhibits synthesis of Vit K dependant clotting factors
c) - ie 2, 7, 9 & 10.
d) - Effect reduced by: Enzyme inducers eg anticonvulsants, Rifampicin,
e) - Griseofulvin also Vit K, O/C.

2) Impaired elimination of the following drugs occurs in renal failure

T a) Chlorpropamide A Sulphonyl-urea (long acting)

F b) Warfarin
T c) Streptomycin An Aminoglycoside like Gentamycin
T d) Morphine All opiates excreted in urine as Glucuronide
T e) Benzyl-Penicillin Virtually all antibiotics are excreted renally

3) The following may potentiate the action of Sulphonyl ureas

T a) Chloramphenicol FX potentiated by Chloramphenicol, Co-trimoxazole, Phe- butazone,

F b) Phenobarbitone Miconazole, Clofibrate, Sulphinpyrazone.
T c) Sulphadimidine
T d) Phenylbutazone
F e) Heparin

4) The following drugs have oxytocic like activity

T a) Vasopressin Does give some uterine stim because of structural similarity to oxytocin
T b) Ergometrine Amine alkaloid
T c) PGE2
F d) Trichloroethylene
F e) Halothane

5) Complications of Methotrexate Rx include

T a) Stomatitis
T b) Diarrhoea
T c) Anaemia
F d) Tinnitis
T e) Allopecia

6) Halothane produces
Non-irritant, non-flammable. Liquid @ room temp
F a) Bronchial irritation 80% excreted unchanged in expired air (therefore must use
F b) Explosive with air closed anaesthetic circuit) 20% metabolised in liver.
T c) Uterine relaxation Hepatic damage(rare) may manifest 10ds after exposure.
T d) Hepatotoxicity with prolonged use Multiple exposures over a short period of time increase
T e) Hypotension this risk. Depresses Resp & myocardium & causes
T f) Hyperglycaemia vasodil & hypotension.
7) Neostigmine
An anti Choline Esterase drug(cf Distigmine, Edrophonium)
T a) Inhibits hydrolysis of ACh which increases ACh & so potentiates neuromuscular
F b) Causes paralytic ileus transmission. Used in myasthenia gravis & urinary
F c) Lasts for several days retension. Side FX due to excessive PS stimulation causing
T d) Is beneficial in Myasthenia Gravis diarrhoea, salivation, colic etc. Can be given with
F e) Is used to reverse the action of anticholinergic (eg Atropine) to minimise side FX.
Carbachol Carbachol has a similar action & is used un retension too.

8) Lignocaine

F a) Action more prolonged than bupivicaine

b)
F c) Used with Adrenaline in ring blocks
T d) Weak base
e)

9) Morphine

T a) Causes constipation
F b) Contraindicated with metoclopramide
c)
d)
e)

10) Action of drugs

T a) Ergometrine - stimulates alpha Also acts on 5HT receptors

receptors in uterus
F b) Indomethacin - effective by PG Inhibits PG synthesis by blocking Cyclo-oxygenase
receptor blockade
c)
d)
e)

11) Drugs exciting the uterus

T a) PGE2
F b) Nifedipine
F c) Hydrallazine
F d) Mefanemic acid
T e) Vasopressin

12) Akylating agents

T a) Cyclophosphamide
F b) Flurouracil An antimetabolite(blocks Thymidylate synthetase)
F c) Methotrexate An aantimetabolite (blocks Dihydrofolate Reductase)
T d) Chlorambucil
F e) Mercaptopurine An antimetabolite(along with AZT)

13) Naloxone antagonises respiratory depression caused by

F a) Thiopentone
T b) Pethidine
c) Pentazocine
F d) Glutethimde
T e) Diamorphine

14) The following are mainly progestogens

F a) Buserelin
T b) Dydrogesterone
T c) Norethisterone
T d) 17-a-hydroxyprogesterone
F e) Androstenedione

15) Suxamethonium is

F a) A non-depolarising agent V short action (5mins). Broken down by

F b) Given with Thiopentone as a plasma Choline Esterase. Side FX include
combined injection at induction bradycardia, muscle pain, raised IOP.
F c) Reversed by Neostigmine Some people have enzyme defect which
T d) Duration is longer than Tubocurarine prolongs duration of action.

16) The following reduce uterine activity

F a) MgSO4
T b) Ritodrine
T c) Isoprenaline A beta agonist like Ritodrine so should relax uterus
d)
e)

17) Nalorphine reverses the respiratory effects of

T a) Diamorphine
F b) Alcohol
T c) Pethidine
F d) Thiopentone
F e) Diazepam

18) Which of the first drugs are potentiated by the second

F a) Phenytoin - Ethinyl oestradiol Phenytoin will decrease efficacy of COC

F b) Warfarin - Phenobarbitone Inhibits due to liver enzyme induction
T c) Lithium - Thiazide diuretics Potentiated due to reduced Lithium clearance
T d) Penecillin - Probenecid Blocks tubuler excretion
F e) Bromocriptine - Metpoclopramide Antagonism of hypoprolactinaemic effect

19) Gentamicin

F a) Is inactivated in the stomach

T b) Causes 8th nerve palsy
T c) Toxicity is accentuated by Frusemide
T d) Excreted mainly by the kidney
e)

20) The following are effective when taken orally

F a) Streptomicin
T b) Tetracycline
T c) Nifedipine
F d) Chloramphenicol
F e) Gentamicin

21) Isoprenaline

F a) Affects mainly alpha receptors

F b) Causes bradycardia
T c) can cause bronchodilation
F d) Potentiated by Propranolol A Beta blocker
F e) Can be given sublingually

22) Carbimazole

F a) Causes neonatal hyperthyroidism

T b) Is secreted in the breast milk
T c) Causes agranulocytosis
d) Is a thiourea
e)

23) Effect of oral contraceptive is decreased by

F a) Bromocriptine
F b) Digoxin
T c) Rifampicin
T d) Ampicillin
T e) Phenytoin

24) Gentamicin
Aminoglycoside. Ototoxic & nephrotoxic.
T a) Ineffective orally Good against Gm-ve aerobes (Proteus/Pseudomonas)
F b) Bacteriostatic Synergistic with penicillin vs Strep
T c) Excreted in urine Bactericidal.
T d) Is toxic to 8th cranial nerve
T e) Frusemide enhances toxicity

25) Isoprenalin
A beta agonist. Main action on B2 in lung giving
F a) Can be given sublingually bronchodilation. Also stims B2 in heart causing
F b) Acts minimally on alpha receptors tachycardia.
F c) Causes bradycardia
F d) Increases respiratory rate
T e) Causes bronchodilation

26) Tetracyclines

F a) Are bacteriocidal
F b) Excreted in the urine
T c) Cause liver damage in pregnancy
T d) Are concentrated in bile
T e) Depress protein anabolism
Bacteriostatic. Excreted unchanged in bile.
Bind with 30S ribosomal unit & upset protein synthesis
Hepatotoxic in pregnancy.
Causes discolouration of growing bones therefore not
used in children/pregnancies.
Impair protein synthesis & contrindicated in renal Dx.

27) Which are MAOI's

F a) Hydrallazine
T b) Phenelzine
T c) Iproniazid
T d) Tranylcypromine
F e) Chlorpromazine
28) Bromocritptine

T a) Is a dopamine receptor agonist Promotes GH release in normal subjects but decreases it

T b) Inhibits prolactin release in acromegally. Excreted in bile.
T c) Promotes GH release Side FX=postural hypotension, nausea, psychiatric FX
T d) Is an ergot derivative
F e) Is oxytocic

29) Which give uterine relaxation

F a) Atropine
T b) Halothane
F c) Morphine sulphate
T d) Amyl nittrite
T e) Alcohol

30) PGF2alpha
Modified FA.
F a) Is a naturally occuring polypeptide
T b) Causes uterine contraction
F c) Lowers diastolic BP
T d) Synthesis inhibited by aspirin
F e) Causes water retention

31) Which of the following are true of anti-hypertensives

T a) Guanethidine blocks post ganglionic transmissionBlocks release of NA & depletes nerve

T b) Ganglion blockers have max effect on BP in endings of NA. No effect on supine
BP.
erect posture
F c) Reserpine causes SLE-like state Hydralazine causes this
T d) Guanethidine causes failure to ejaculate
F e) Me DOPA acts as ganglion blocker

32) Which of the following drugs are ineffective when taken by mouth

F a) Probenecid
T b) Heparin
F c) Cyclophosphamide
T d) Suxamethonium
F e) Methicillin

33) Atropine causes

T a) Increased heart rate

F b) Vasodilation of the skin
T c) Reduced saliva
F d) Overactivity of the small intestine
F e) Reduced gastric secretion

34) Vasopressin

F a) Causes diuresis
F b) Raises BP in therapeutic doses
T c) Secretion is stimulated by nicotine
F d) In therapeutic doses causes intestinal colic
T e) Secretion stimulated by increased osmotic
pressure of blood supplying the hypothallamus

35) Morphine

T a) Causes vasodilation
F b) Lowers BP
F c) Reduces intestinal tone
T d) Causes respiratory acidosis
F e) Has anticonvulsant properties

36) Chloramphenicol

T a) Has a nitrobenzine group V broad spectrum. Use limited by bone marrow suppression
F b) Has a narrow range of activity Contraindicated in neonates because of CV collapse
T c) Effective against Gm -ve
T d) Metabolised in the liver
T e) Can cause leucopaenia

37) Streptomicin

F a) Is excreted actively in renal tubules

F b) Bacteriostatic
T c) May cause 'Drug Fever'
F d) Is destroyed in stomach
F e) Broken down in liver

38) Morphine

T a) Is metabolised in the liver

F b) Impairs conduction in sensory nerves
F c) Depresses vomiting centre
T d) Constricts pupils
T e) Stimulates vasopressin release
Pharmant©